Orthopedics in Montana | Nonsurgical treatment options for knee pain
Your physician may prescribe oral medications for the relief of arthritis pain or joint pain. This can include pills with Aspirin, ibuprofen and naproxen which can relieve pain and reduce inflammation.
If oral medications fail to provide relief, your orthopedic surgeon may recommend an injection of medication into the joint. An injections can offer quick, effective pain relief. However, joint injections with either cortisone, steroids or other medication have limits because over time excessive use can damage the joint.
Knee orthotics and braces
In some cases, knee pain can be alleviated by something as simple as using a foot orthotic or knee brace. Foot orthotics are orthopedic devices like insoles or supports that are usually custom fit to control the foot and correct imbalances. An orthotic foot support can raise the arch of the foot and realign the bones of the foot to prevent excess motion when you bear weight. Foot problems can sometimes cause ankle, knee, hip, and back problems.
If you are an avid runner, and you are suffering from knee problems, you may want to explore an orthotic foot device. The device could position your foot in such a way that knee pain could be alleviated.
Many times, improper foot mechanics leads to improper running or other physical motion, and this can damage the knee. If you are suffering from arthritis, or you are overweight, the foot orthotic could help by repositioning your foot and counteracting stress on your knee to allow greater comfort and mobility for greater lengths of time. Orthotics come in rigid, semi-rigid, and soft materials. The rigid materials are generally prescribed when entire control and support is needed. The semi-rigid materials offer support, but they also allow for shock absorption.
Knee braces can be used to help an existing knee injury, or to protect the knee from future injury. Before these devices are used, you should consult with a physician. If worn improperly, the brace could do damage, and wearing it for a long period of time would not allow the muscles around your knee to grow stronger.
A study from the Surgical Clinic of the Ullevaal Hospital at the University of Oslo in Norway found that patients in their study using a knee brace after anterior cruciate ligament (ACL) reconstruction had increased thigh atrophy after wearing the brace for three months.
Said another way, using a brace is like using a crutch. While it can help you become active after an injury, depending upon it excessively doesn’t encourage the supporting muscles to strengthen. And in a sense, you become dependent upon that crutch, so when it isn’t there, you can have problems.
With that said, a subliminal function of a knee brace is that it can act like a string around your finger—to remind you to be careful during activity, and not be overly aggressive with the knee joint.
Hyaluronic Acid for a degenerative knee joint
Hyaluronic acid injection is used to treat osteoarthritis. Hyaluronic acid is similar to the natural synovial fluid found in the joints. It works by acting like a lubricant and shock absorber in the joints and helps the joints to work properly.
During the procedure, the orthopedic specialist injects hyaluronic acid directly into your knee joint. The injection is repeated for up to 3 to 5 weeks. While the FDA has approved this treatment only for osteoarthritis of the knee, some use it for other arthritic joints as well as they report that it acts like lubricant in the joint.
Hyaluronic acid injections do not seem to work for all people. Those who are older or have advanced arthritis, may be less likely to find relief from these injections. Generally speaking, Hyaluronic Acid is often a last resort before more invasive knee surgery.
There can be some swelling in the knee area as a side effect of the injection. One study in 2016 in the journal Systematic Reviews found the possibility of serious side effects outweighed the benefits.
Another non-surgical treatment option that is being explored is the use of tiny pellets that might treat arthritic knee pain, delaying the need for knee replacement surgery.
A small study by the Society of Interventional Radiology found that inserting micro-particles into small blood vessels around the knee reduced pain and improved function. The tiny micro-particles — spheres about a tenth of a millimeter in size — are made from a synthetic gel-like material. The micro-particles are inserted using a catheter run through a pinhole-sized incision, in a procedure that lasts between 45 and 90 minutes. While the research is preliminary, they have noted some patients experienced relief of symptoms from the procedure.
Knee therapists & customized exercises
For someone suffering knee pain the mere thought of exercise can be painful. For most knee problems specific exercises help rehabilitate injured tissues, strengthen weak muscles, and improve flexibility and range of motion.
A therapist who is specialized in knees can help an athlete rehab a partially torn ligament to avoid surgery. A knee therapist can also customize exercises that simulate the activity you hope to return to (e.g. golf, tennis, running) to strengthen the knee joint and lessen risk of injury. Same can be said for rehabilitating the knee after a surgical procedure to regain normal range of motion.
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